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The prescription cost playbook — explained.
Plain-English guides to navigating insurance, appeals, copay cards, and patient assistance. Written by the RxCopays editorial team, cited against primary sources, updated when policy changes.
7 min read
What is prior authorization and how do I appeal a denial?
Prior authorization is the insurance barrier most patients encounter first. Here's what it is, why it exists, and exactly how to appeal when you get denied.
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8 min read
How to apply for a Patient Assistance Program (PAP)
Step-by-step walkthrough of applying to a manufacturer PAP — eligibility rules, what documents you need, typical wait times, and when to escalate.
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6 min read
Copay cards explained: what they cover, who can use them, and the fine print
Manufacturer copay cards can cut a $500 monthly copay to $10 — but they come with rules. Here's who qualifies and what to watch for.
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9 min read
Medicare Part D drug tiers, decoded
Tier 1, Tier 2, Tier 4, non-formulary. What those numbers actually mean for your copay, and how to get a drug moved to a lower tier.
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8 min read
Cost Plus Drugs vs. traditional pharmacies — when does transparent pricing win?
Mark Cuban's Cost Plus Drug Company prices drugs at manufacturer cost + 15% + $5 dispensing. We compare it head-to-head with insurance pricing.
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10 min read
Specialty drugs: why they cost $50,000+ and what to do about it
A biologic for rheumatoid arthritis can cost $70k/year. Here's why specialty drugs are priced that way and the playbook patients use to afford them.
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7 min read
Medicare Extra Help (LIS) — free or near-free drugs if you qualify
The Low Income Subsidy cuts Part D premiums, deductibles, and copays to near zero. It's underused — more than 2 million eligible seniors aren't enrolled.
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9 min read
The 5-level appeal: winning a Medicare Part D denial
Every Medicare PA denial has 5 appeal levels. Most patients stop at level 1; those who go to level 3 win ~60% of the time. Step-by-step playbook.
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6 min read
GoodRx vs. your manufacturer copay card — when each wins
They're not the same thing and you often can't stack them. A quick decision tree for which to use based on your insurance, drug tier, and retail price.
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8 min read
The $2,000 Medicare Part D cap — what actually changes in 2026
The IRA's $2,000 annual out-of-pocket cap is the biggest Part D change in 20 years. Here's how it works, who benefits, and what stays the same.
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7 min read
How to read your insurance formulary (without losing your mind)
Your plan's drug list tells you tier, PA, step therapy, and quantity limits. Once you know where to look, you can predict your copay before the pharmacy does.
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